急性心肌梗塞後之運動訓練

急性心肌梗塞死亡率自1970年代後逐年下降，但疾病的發生率與再發率卻持續上升，造成失能、心理、家庭與經濟等問題。已有研究指出，其中一個重要原因是多數急性心肌梗塞患者未在出院後接受持續次級預防照護與運動訓練，但心肌梗塞病人常有許多共同病症與較複雜的病情，運動處方可參考之指引不多。本文目的為進行文獻回顧，探討急性心肌梗塞病患接受運動介入之成效與建議處方。回顧過去研究發現，心肌梗塞後之病患接受心臟復健中發生危險事件的比例相當低；但仍需運動訓練前的風險與運動測試評估，且待生理狀態穩定才能開始接受運動訓練。病人可於住院期間即開始接受心臟復健，並可於心肌梗塞後5－14天後進行低強度之運動測試。通常建議以有氧運動為主，阻力運動為輔。有氧運動強調為中高強度以下、節律重複性以及大肌肉群的運動。有氧運動頻率建議為每週3－7次，每次30－60分鐘。運動全程分為暖身期、有氧訓練期與緩和期。運動強度可參考運動測試之60－75％尖峰攝氧量／尖峰心跳量或者以40－85％心跳儲備量為目標強度。過去研究發現病患在急性心肌梗塞後接受運動訓練約6－12周時可達到良好成效，包含死亡率與再發率、臨床生理狀況、活動體能、心理症狀以及健康相關生活品質等多面向皆有效益。

關鍵字

急性心肌梗塞；運動訓練；治療計畫

並列摘要

Acute myocardial infarction is a major cause of dysfunction and has high prevalence and recurrent rate. Although exercise is a key issue in secondary prevention, cardiac rehabilitation have not been consist of training protocol. The objective of this study was to investigate the exercise recommendation and outcome of patients with acute myocardial infarction by article review. There is evidence to suggest that exercise training and exercise testing is safe in most patients emerged from acute myocardial infarction. The importance of risk evaluation though exercise testing prior to starting training program should be emphasized. Physical activity during hospitalization is initiated under physiotherapist supervision. Submaximal exercise testing is usually performed at 5-14 days after cardiac event. Aerobic exercise is the most suggested option and could be performed 3-7 times per week with reported training sessions of 30-60 minutes duration. As prescription as moderate to high intensity, the target zone will be set as 60-75% peak oxygen uptake/heart rate or 40-85% heart rate reserve. Evidence supports that optimal exercise training for 6-12 weeks will result in secondary prevention of cardiac event and is effective in physical capacity, psychological symptoms and quality of life.

並列關鍵字

Acute myocardial infarction ； Exercise training ； Protocol

國際替代計量

急性心肌梗塞後之運動訓練

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